Not Every Headache Warrants a Head CT: A Recurrent Headache Unveiling H. Pylori-Positive MALToma.

Abstract

Helicobacter pylori (H. pylori) is a urease-producing bacterium that has a tendency to colonize the gastric mucosa. H. pylori can cause atrophic gastritis and gastric intestinal metaplasia (GIM). H. pylori has also been associated with MALT lymphoma, which is an extranodal marginal zone lymphoma. The gold standard for the diagnosis of H. pylori is histopathological analysis from biopsied gastric mucosa. MALT lymhoma can have a wide range of clinical manifestations, such as epigastric pain, iron-deficiency anemia, and overt upper gastrointestinal (GI) bleeding. MALT lymphoma has been rarely associated with headaches. We describe a case of H. pylori-positive MALToma manifesting as epigastric pain occurring concomitantly with throbbing headaches; hence, headache can be a heralding symptom for the diagnosis of MALToma.